Corporate Headquarters
139 Mill Rock Road East
Old Saybrook, CT 06475
800-966-0664

Donation

Three Easy Ways to Donate:

  1. Complete form below and submit online (* is required)
  2. Print and mail to:
    Vehicle Donation Processing Center
    139 Mill Rock Road East
    Old Saybrook, CT 06475
  3. Fax to 860-388-4477 or call 800-966-0664 and we can process your donation over the phone.
Charity Name*
Name*     Street*
City* State* Zip*
Best/Day time Phone* Cell Email
Vehicle Make* Model* Year*
Color* Mileage*
Vehicle ID # (VIN)*
Location of vehicle if different from above
Is the title free and clear of lien?    
Can vehicle be driven 20 miles? Yes No       If car cannot be driven 20 miles, state the reason:

Vehicle must be accessible by flatbed tow truck (i.e. driveway)?

Check off areas of damage
Right Front Left Front Hood
Right Rear Left Rear Trunk
Right Side Left Side Roof
Note: The vehicle MUST have a title, no liens, and four inflated tires and have a complete engine to be accepted into our program. Please remove license plates and all personal items from vehicle before scheduled pick-up date and place the title and keys in the glove box. Donor signs name on seller location on back of title and charity name is listed as buyer.

How did you hear about our program?

Radio
Please specify:
Friend/Relative
Please specify:
Mailing
Kind:
Newspaper
Which one?
Emissions Station 
Please specify:
Billboard
Location?
2nd Time Donor 
Please specify:
Other
Please specify:
Comments:
  Thank You For Your Donation